Why do I feel mild pain in my knee, fingers and elbow joints during Urate Lowering Therapy.

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Hi everyone

I am on Urate lowering therapy for last 2 months. I am taking febuxostat 40mg Tablets daily. My serum urate level is 5.7 mg/dl. But I sometimes feel slight pain or even twinges in my knee , elbow, fingers and foot joints. This pain is not that much severe so I don't want to call it gout flare-up. Please tell me do we feel this kind of slight/mild pain even if our urate levels are well within range? Is this pain related to crystal dissolution? I also feel little bit burning sensation in these joints.

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8 Replies

  • Posted

    5.7 mg/dl, I would not class as within range for Gout person.

    For non Gout, yes.

    You should aim for under 5mg/dl. Depending on how long you had Gout it will take lot longer for all crystals deposits to dissolve.

    I have been on Allopurinol 300mg for last 10 years. Zero pain.

    • Posted

      At which value you maintain your serum urate level?

  • Posted

    Was this after a gout attack, or did the beginning of the therapy cause an attack?

    Even without an attack, yes, the clearing out of the crystals could easily cause various twinges for a couple of months, just be glad it's not much worse!

    • Posted

      I started the therapy after gout attack.

    • Posted

      Hammi, an actual attack may do some irritation and damage to joints that takes time to clear completely, so some little pains might have followed in any case.

  • Posted

    firstly the level of 5.7 is too high. The NICE recommended level is under 3.

    Second, when you first take urate lowering therapy you release stores of crystals which have till then been covered by protein. as these crystals are exposed you will get gout. The way to stop this is a small dose of colchicine again as recommended by NICE.

    Like worriedH I've been on allopurinol for a decade with no issues.

    i thought they were cutting down use of Februxsat due to increased heart attack risk compared to allopurinol?

    Good luck!

    • Posted

      I am also thinking to switch to allopurinol. I guess in USA or other developed countries they do not prescribe febuxostat. But how come a medicine (allopurinol) way more cheaper than febuxostat has less side effects?

  • Posted

    Allopurinol has been around for 60 plus years. It is dirt cheap - costsvperhaps $12 per year. There arev ome minor side effects, andbone vety serious side effect which overwhelmingly effects Chinese Thais and Koreans (genes). Fabruxsat is new and seemed to be better, but its expensive and allopurinol foes the job well, si in a public health system, why pay for a dug 50x more expensive? it then turned out that Febrruxsat had a higher heart attack risk, so in the UK at least its very much only used if the patient cant handle allopurinol.

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